• Pablo Jorge-Monjas, Juan Bustamante-Munguira, Mario Lorenzo, María Heredia-Rodríguez, Inmaculada Fierro, Esther Gómez-Sánchez, Alfonso Hernandez, Francisco J Álvarez, Jesús F Bermejo-Martin, Estefanía Gómez-Pesquera, José I Gómez-Herreras, and Eduardo Tamayo.
• Department of Anesthesiology and Reanimation, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
• J Crit Care. 2016 Feb 1; 31 (1): 130-8.

PurposeAcute kidney injury (AKI) is a frequent complication after cardiac surgery and is associated with increased mortality. The aim was to design a nondialytic AKI score in patients with previously normal renal function undergoing cardiac surgery.MethodsData were collected on 909 patients who underwent cardiac surgery with cardiopulmonary bypass between 2012 and 2014. A total of 810 patients fulfilled the inclusion criteria. Patients were classified as having AKI based on the RIFLE criteria. Postoperative AKI occurred in 137 patients (16.9%). Several parameters were recorded preoperatively, intraoperatively, and at intensive care unit admission, looking for a univariate and multivariate association with AKI risk. A second data set of 741 patients, from 2 different hospitals, was recorded as a validation cohort.ResultsFour independent risk factors were included in the CRATE score: creatinine (odds ratio [OR], 9.66; 95% confidence interval [CI], 4.77-19.56; P < .001), EuroSCORE (OR, 1.40; CI, 1.29-1.52; P < .001), lactate (OR, 1.03; CI, 1.01-1.04; P < .001), and cardiopulmonary bypass time (OR, 1.01; CI, 1.01-1.02; P < .001). The accuracy of the model was good, with an area under the curve of 0.89 (CI, 0.85-0.92). The CRATE score retained good discrimination in validation cohort, with an area under the curve of 0.81 (95% CI, 0.78-0.85).ConclusionsCRATE score is an accurate and easy to calculate risk score that uses affordable and widely available variables in the routine care surgical patients.Copyright © 2015. Published by Elsevier Inc.

33 keywords...

hide…